MA S529

Bill

Relative to administrative simplification

Introduced
01/23/2017

In Committee
01/23/2017

Crossed Over

Passed

Dead
12/31/2018

Introduced Session

190th General Court

Bill Summary

For legislation relative to evidence of coverage to be delivered to covered adults by health, dental and vision care providers. Financial Services.

AI Summary

This bill amends the General Laws of Massachusetts to require health, dental, and vision care providers to make determinations regarding the medical necessity of proposed admissions, procedures, or services within specific timeframes. Specifically, it mandates that carriers or utilization review organizations must make such determinations within two working days of obtaining all necessary information, and provide notification to the provider within 24 hours. In the case of adverse determinations, the carrier or utilization review organization must notify the provider within 24 hours and provide written or electronic confirmation to the insured and the provider within one working day. The bill also sets out requirements for concurrent review determinations, including the timeframes for notification of the provider and insured in cases of approval or adverse determination.

Committee Categories

Business and Industry

Sponsors (1)

Linda Forry (D),

Last Action

Accompanied a study order, see S2496 (on 04/30/2018)

Official Document

https://malegislature.gov/Bills/190/S529

(17 Companion Bills)

Version:

Document Type	Source Location
State Bill Page	https://malegislature.gov/Bills/190/S529
Bill	https://malegislature.gov/Bills/190/S529.pdf

Bill	Bill Name	Last Action	Type
H1408	Relative to access to health insurance for human service providers and their employees	Accompanied a study order, see H4778	Similar To
H2162	Relative to prescription drug voice synthesizers	Accompanied a study order, see H4778	Similar To
H4865	Relative to certain genetically targeted drug coverage for Duchenne Muscular Dystrophy	Read; and referred to the committee on Senate Ways and Means	Similar To
H536	Relative to advancing contraceptive coverage and economic security in our state (ACCESS)	Accompanied a new draft, see H4009	Similar To
H551	Relative to anesthesia coverage for children hospitalized for dental treatment	Accompanied a study order, see H4778	Similar To
H576	Making corrective amendments to Chapter 234 of the Acts of 2012 47CC	No further action taken	Similar To
H588	Expanding automobile insurance coverage options to include the diminished value of automobiles	Accompanied a study order, see H4778	Similar To
H598	To ensure continued health insurance coverage for children	Accompanied a study order, see H4528	Similar To
S1215	To reduce healthcare costs by promoting non-biased prescriber education	Committee recommended ought to pass and referred to the committee on Senate Ways and Means	Similar To
S2496	Order relative to authorizing the joint committee on Financial Services to make an investigation and study of certain current Senate documents relative to financial services issues	Discharged to the committee on Senate Rules	Replaced by
S514	Providing for coverage of necessary aqua therapy	Accompanied a study order, see S2496	Similar To
S551	Reducing health care costs through improved medication management	Accompanied a study order, see S2496	Similar To
S554	Relative to insurance coverage for mammograms and breast cancer screening	Accompanied a study order, see S2496	Similar To
S557	Promoting consumer choice in health care	Accompanied a study order, see S2496	Similar To
S578	Relative to notice requirements for insurance premium changes and insurance coverage changes	Accompanied a study order, see S2496	Similar To
S616	Providing health insurance coverage for cochlear and auditory osseointegrated implants in children	Accompanied a study order, see S2535	Similar To
S647	Ensuring continued health insurance coverage for children	Accompanied a study order, see S2535	Similar To

Bill

Bill Name

Last Action

Type

H1408

Relative to access to health insurance for human service providers and their employees

Accompanied a study order, see H4778

Similar To

H2162

Relative to prescription drug voice synthesizers

Accompanied a study order, see H4778

Similar To

H4865

Relative to certain genetically targeted drug coverage for Duchenne Muscular Dystrophy

Read; and referred to the committee on Senate Ways and Means

Similar To

H536

Relative to advancing contraceptive coverage and economic security in our state (ACCESS)

Accompanied a new draft, see H4009

Similar To

H551

Relative to anesthesia coverage for children hospitalized for dental treatment

Accompanied a study order, see H4778

Similar To

H576

Making corrective amendments to Chapter 234 of the Acts of 2012 47CC

No further action taken

Similar To

H588

Expanding automobile insurance coverage options to include the diminished value of automobiles

Accompanied a study order, see H4778

Similar To

H598

To ensure continued health insurance coverage for children

Accompanied a study order, see H4528

Similar To

S1215

To reduce healthcare costs by promoting non-biased prescriber education

Committee recommended ought to pass and referred to the committee on Senate Ways and Means

Similar To

S2496

Order relative to authorizing the joint committee on Financial Services to make an investigation and study of certain current Senate documents relative to financial services issues

Discharged to the committee on Senate Rules

Replaced by

S514

Providing for coverage of necessary aqua therapy